Resting-State Functional Connectivity and Cognition After Major Cardiac Surgery in Older Adults without Preoperative Cognitive Impairment: Preliminary Findings.
Abstract
OBJECTIVES: To look for changes in intrinsic functional brain connectivity associated
with postoperative changes in cognition, a common complication in seniors undergoing
major surgery, using resting-state functional magnetic resonance imaging. DESIGN:
Objective cognitive testing and functional brain imaging were prospectively performed
at preoperative baseline and 6 weeks after surgery and at the same time intervals
in nonsurgical controls. SETTING: Academic medical center. PARTICIPANTS: Older adults
undergoing cardiac surgery (n = 12) and nonsurgical older adult controls with a history
of coronary artery disease (n = 12); no participants had cognitive impairment at preoperative
baseline (Mini-Mental State Examination score >27). MEASUREMENTS: Differences in resting-state
functional connectivity (RSFC) and global cognitive change relationships were assessed
using a voxel-wise intrinsic connectivity method, controlling for demographic factors
and pre- and perioperative cerebral white matter disease volume. Analyses were corrected
for multiple comparisons (false discovery rate P < .01). RESULTS: Global cognitive
change after cardiac surgery was significantly associated with intrinsic RSFC changes
in regions of the posterior cingulate cortex and right superior frontal gyrus-anatomical
and functional locations of the brain's default mode network (DMN). No statistically
significant relationships were found between global cognitive change and RSFC change
in nonsurgical controls. CONCLUSION: Clinicians have long known that some older adults
develop postoperative cognitive dysfunction (POCD) after anesthesia and surgery, yet
the neurobiological correlates of POCD are not well defined. The current results suggest
that altered RSFC in specific DMN regions is positively correlated with global cognitive
change 6 weeks after cardiac surgery, suggesting that DMN activity and connectivity
could be important diagnostic markers of POCD or intervention targets for potential
POCD treatment efforts.
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https://hdl.handle.net/10161/13329Published Version (Please cite this version)
10.1111/jgs.14534Publication Info
(2017). Resting-State Functional Connectivity and Cognition After Major Cardiac Surgery in
Older Adults without Preoperative Cognitive Impairment: Preliminary Findings. J Am Geriatr Soc, 65(1). pp. e6-e12. 10.1111/jgs.14534. Retrieved from https://hdl.handle.net/10161/13329.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
John Hunter Peel Alexander
Professor of Medicine
John H. Alexander, MD, MHS is a cardiologist and Professor of Medicine in the Department
of Medicine, Division of Cardiology at Duke University School of Medicine, as well
as the Vice Chief, Clinical Research in the Division of Cardiology. He is the Director
of Cardiovascular Research at the Duke Clinical Research Institute where he oversees
a large group of clinical research faculty and a broad portfolio of cardiovascular
clinical trials and observational clinical research programs. He is a
Miles Berger
Associate Professor of Anesthesiology
My research team focuses on 3 areas:1) We are interested in the mechanisms of postoperative
neurocognitive disorders such as delirium, and the relationship between these disorders
and Alzheimer's Disease and Related Dementias (ADRD). Towards these ends, we use a
combination of methods including pre and postoperative CSF and blood sampling, functional
neuroimaging, EEG recordings, rigorous biochemical assays, and cognitive testing and
delirium screening. In the long run, this work has
Jeffrey Nicholas Browndyke
Associate Professor of Psychiatry and Behavioral Sciences
Dr. Browndyke is an Associate Professor of Behavioral Health & Neurosciences in the
Department of Psychiatry & Behavioral Sciences. He has a secondary appointment as
Assistant Professor of Cardiovascular & Thoracic Surgery.Dr. Browndyke's research
interests involve the use of advanced neurocognitive and neuroimaging techniques for
perioperative contributions to delirium and later dementia risk, monitoring of late-life
neuropathological disease progression, and inter
Jeffrey Giles Gaca
Associate Professor of Surgery
Todd B Harshbarger
Assistant Professor in Radiology
Joseph P. Mathew
Jerry Reves, M.D. Distinguished Professor of Cardiac Anesthesiology
Current research interests include:1. The relationship between white matter patency,
functional connectivity (fMRI) and neurocognitive function following cardiac surgery.2.
The relationship between global and regional cortical beta-amyloid deposition and
postoperative cognitive decline.3. The effect of lidocaine infusion upon neurocognitive
function following cardiac surgery.4. The association between genotype and outcome
after cardiac surgery.5. Atrial fibrillation
Mark Franklin Newman
Merel H. Harmel Distinguished Professor Emeritus of Anesthesiology
Best known for his work in assessing and improving clinical outcomes and quality of
life following cardiac surgery, Dr. Mark Newman is President of the Duke Private Diagnostic
Clinic (The Duke Faculty Practice Organization) and the Merel H. Harmel Professor
of Anesthesiology at Duke University Medical Center. In addition, Dr. Newman developed
the Multicenter Perioperative Outcomes Research Group of the Duke Clinical Research
Institute established at Duke in 2001 to further the study of strategie
Patrick J Smith
Associate Professor in Psychiatry and Behavioral Sciences
Dr. Smith is interested in the impact of lifestyle interventions, such as diet and
exercise, on neurocognitive function and mood. He has also published multiple studies
examining the relationship between cardiovascular disease, major depressive disorder,
and neurocognitive outcomes, preoperative predictors of postoperative delirium, the
impact of cardiothoracic interventions on neurocognitive outcomes, and the relationship
between patterns of dietary intake and cardiovascular outcomes. He is als
This author no longer has a Scholars@Duke profile, so the information shown here reflects
their Duke status at the time this item was deposited.
Kathleen Anne Welsh-Bohmer
Professor in Psychiatry and Behavioral Sciences
Dr. Kathleen Welsh-Bohmer is a Professor of Psychiatry with a secondary appointment
in the Department of Neurology. Clinically trained as a neuropsychologist, Dr. Welsh-Bohmer's research
activities have been focused around developing effective prevention and treatment
strategies to delay the onset of cognitive disorders occurring in later life. From
2006 through 2018 she directed the Joseph and Kathleen Bryan Alzheimer’s Center
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